Cut back on screen time for kids

Cut back on screen time for kids

When it comes to getting parents to cut back on their kids’ screen time, we doctors aren’t doing such a great job.

Like most of my colleagues, I talk about screen time at almost all checkups. I talk about how too much screen time makes a kid more likely to be overweight and have behavioral problems. With the parents of babies and small children, I talk about how experts think they shouldn’t watch TV at all, and about how it can get in the way of learning. I encourage parents to limit screen time, not have TV’s in bedrooms and turn off the TV at meals. We talk about other things they might do instead.

Their eyes glaze over, and they keep doing what they were doing.

That’s pretty much what happened in a study released in the journal Pediatrics. Researchers in Toronto divided families coming in for the three-year checkup into two groups. One group got some general information about safe media and Internet use. The other got specific counseling about risks of screen time in kids, with suggestions to do all the things I talk about, like budgeting time, getting the TV out of the bedroom, not eating in front of it, etc. A year later they checked in with the families again. There was essentially no change and no difference between the two groups–except that the group that got the counseling now ate 1.6 meals a day in front of the TV instead of 1.9. Which is still, in my opinion, not great–they were still essentially eating half of their meals in front of the TV.

It’s hard to change behavior. For reasons that I don’t entirely understand, it’s particularly hard to change TV behavior–perhaps because TV is convenient, kids like it, and their parents do too. And given that TV is only one of the many things I need to talk about at a checkup, I can’t talk about it for very long.

According to the authors of the study, the only interventions that seem to make a difference when it comes to families and screen time are ones in which parents get talked to a lot–and they usually come from schools or other groups, not doctors. This makes sense. But it’s disappointing.

See, I don’t want to give up. And yet I don’t want to take up valuable time (when kids are well, I might only get to spend 15 or 20 minutes with them a year!) doing something that doesn’t have any effect whatsoever.

So help me out here, you parents reading this post. What’s going on? Do you tune us doctors out? Do you think we’re out of touch, that we don’t get what it’s like to be a parent? Or do you agree with us, but find our advice too hard to follow? What would be more helpful? Is it that there’s too much advice all at once at a checkup? Would it be better if we used mailings or social media (should we Tweet you?) to give you more information and reminders?

Screen time is something that can end up affecting the health and well-being of kids for a lifetime, if kids get into unhealthy media habits. I really want to know: how can I help parents make the best decisions for their kids?

Claire McCarthy is a primary care physician and the medical director of Boston Children’s Hospital’s Martha Eliot Health Center.  She blogs at Thriving, the Boston Children’s Hospital blog, Vector, the Boston Children’s Hospital science and clinical innovation blog, and MD Mama at Boston.com.

Image credit: Shutterstock.com

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  • http://twitter.com/bradcarlson Brad Carlson

    As a parent who does limit screen time (and never, EVER during a meal), I think most parents ignore the advice for one simple reason: it’s hard. It’s painfully difficult and draining to entertain a toddler all day without the TV. But my wife and I make the sacrifice to do it. Sure, when he wants to read the same book for the 15th time in a row, its a lot easier to put the TV on. When driving for two hours in the car, its a lot easier to put an iPad in front of him then to sing kids songs. When we go out to eat, its a lot easier to put my iPhone in front of him then to color a million pictures and try to keep him entertained. It takes a lot more effort to entertain kids ourselves and I think too many parents are already drained from work, family stress, etc. that its just easier to turn on the screen.

  • http://twitter.com/bradcarlson Brad Carlson

    As a parent who does limit screen time (and never, EVER during a meal), I think most parents ignore the advice for one simple reason: it’s hard. It’s painfully difficult and draining to entertain a toddler without the TV. But my wife and I make the sacrifice to do it. Sure, when he wants to read the same book for the 15th time in a row, its a lot easier to put the TV on. When driving for two hours in the car, its a lot easier to put an iPad in front of him then to sing kids songs. When we go out to eat, its a lot easier to put my iPhone in front of him then to color a million pictures and try to keep him entertained. It takes a lot more effort to entertain kids ourselves and I think too many parents are already drained from work, family stress, etc. that its just the easier way to go.

  • Bookworm9798

    We have an eight-year-old and attempt to limit her total daily screen time to two hours per day. This is easier to do with tv shows or movies (which have a set length) and harder to do with Wii games or games on the computer, where a request to “just finish this race” is not wholly unreasonable, but ends up stretching the time spent past the limits. I frequently point to the AAP’s recommendation as the evidence for this rule (not that an elementary age child really cares about evidence, right?) My spouse, who spends more time with our daughter after school and in the summer, doesn’t take it as seriously as I do and I end up being the “enforcer.”

  • valendar

    ok, I agree with the post for the most part. But here’s the kicker, how would you like me telling you how to run your practice? If you like to lecture, become a professor, otherwise keep your mouth shut and focus on your job.

  • southerndoc1

    “When it comes to getting parents to cut back on their kids’ screen time, we doctors aren’t doing such a great job.”

    Maybe because it’s not our job to “get” others to do what we think is good for them.

    • Richard Watt

      Excellent comment. Since when did it become parents’, schools’ etc job to teach children the right thing. The best they can do is reinforce what responsible parent teach their children.

  • Slava Petrov

    I think a lot of couples in this country are so drained by the end of the day that they need to have that 1 hour or 2 in the evening when they can just relax and not be interrupted by their kids. Solution? One income family when Mom or Dad catches up with the things during the day and can spend the time with the kids after 5 pm. We have 2 kids in elementary and my wife works part time while I put in 50-60 hours each week. We don’t have TV, just Netflix but kids play Nintendo DS for 0.5 to 1.5 hours each day. Are we terrible parents? I don’t know but I have to plan things ahead if I want to spend some time with my kids. One of the things we came up this past year is the year-round swimming pool at the local Y. On the YMCA days our kids hardly have any time left for video games.

  • azmd

    Does anyone else besides me find it a little ironic that we are all here, gathered around our computer screens, debating about how to best convince parents to limit their childrens’ screen time?

    Seriously, our culture is increasingly based on screen-related activities. To ask (already tired and stressed) parents to buck this trend in their homes after a full day of work is probably futile.

    Also, I agree with southerndoc: how did it become our job to change our patients’ behaviors? We can certainly provide information that they can act upon if they choose, but ultimately, isn’t it a little paternalistic to see ourselves in the position of being responsible for the choices they make?

    P.S. I am someone who has always strictly limited screen time for my children, but as they get older, and more of their homework is internet-based, it’s become increasingly difficult if not impossible to police.

  • James

    We should dicuss how best to limit doctors’ screen time. Doctors used to have good hearing and active note-taking. Now the screen assumed control of the doctors, and doctors lost much of hearing. Note-taking becomes as easy as clicking, and patients’ complaints turns into ambient sound.

    • southerndoc1

      Zing!

  • CDL

    I think we could educate our Kids on what the affects of screen time are. Sometimes reading the facts from a book or something visual could help them learn to start making good choices for themselves..with our help of course ;) I know I could make a better example at home – instead of getting on the laptop after work I could try to engage in PLAY with my child.

  • http://twitter.com/LisaGuernsey LisaGuernsey

    I find that parents listen when you tilt the conversation to talk about background TV vs. foreground TV and stress that the *content* and *context* of watching matters. As a mom, I wanted to feel empowered to make good choices and set up workable solutions, instead of feeling like I was having to resort to bad habits caused by stressful work schedules and lack of child care support, etc. I interviewed many families for my book Screen Time: How Electronic Media — from Baby Videos to Educational Software — Affects Your Young Child. Parents provided a multitude of ideas for workable solutions (listed in chap 12) but only the parents in two-parent households with child-care help were limiting screen time in ways that the AAP suggests.

  • http://www.facebook.com/fbutera1 Frank Butera

    One of the first things I was taught in med school psychiatry: people don’t take advice that they haven’t asked for.
    Also, after 30 years of pediatrics, I have found that most (though not all) parents really listen to me when giving advice about treating an illness, but don’t seem to consider me much of an expert when giving unsolicited parenting advice.
    This is an important topic, but would be more successfully adressed through schools, churches, scouting, and other community organizations.

  • http://twitter.com/DrGwenn Dr. Gwenn

    Great post, Claire. It can be discouraging when parents don’t seen to “listen” in some settings but do “listen” in others. Don’t be discouraged, though. I’ve shared your experience in the office many times but I’ve also had other times in the community and online when I know I’m reaching people. Its by being available to our families in every setting that the message sinks in.

    The more I engage with parents in many settings, the more I recognize that its the community time they value the most for getting the information they seek and being able to ask questions.

    However, by knowing their pediatricians is media-savvy, they’ll know who to turn to if media issues arise. So, we can’t stop bringing up these important issues. Perhaps we won’t have a deep discussion or the message won’t sink in as we hoped it would. But, that may not be the point of mentioning the message. Perhaps bringing up media issues is important just to keep the door open to a new health issue that parents may not realize exists until a problem occurs.

    I’ve heard from many parents that their pediatricians never discuss TV, cyberbullying, sexting and the many issues we know are important. They have no idea who to turn to if, or when, issues occur with their digital kids. By you bringing up the issues, your families know.

    Sometimes its not what is said but implied that matters in our shrinking time with families.

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